[宫颈上皮内瘤变2级和3级女性肛管中HPV诱导病变的患病率：横断面研究]
[Prevalence of HPV-induced lesions in the anal canal among women with cervical intraepithelial neoplasia 2 and 3: cross-sectional study].
作者信息
Heráclio Sandra de Andrade, de Araujo Thaís Antunes, Souza Alex Sandro Rolland, Cahen Kristiane, Lima Junior Sergio Ferreira, de Souza Paulo Roberto Eleutério, Amorim Melania Maria Ramos
机构信息
Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil.
Faculdade Pernambucana de Saúde, Recife, PE, Brasil.
出版信息
Rev Bras Ginecol Obstet. 2015 Oct;37(10):480-5. doi: 10.1590/SO100-720320150005279.
PURPOSE
To determine the prevalence of HPV-induced lesions in the anal canal of women with cervical intraepithelial neoplasia (CIN) grade 2/3.
METHODS
A cross-sectional study was carried out from December 2008 to June 2009, in Pernambuco, northeastern Brazil. Only women with grade 2/3 CIN were included, and those who could not undergo anoscopy during their first visit were excluded. A cyttobrush was used for sample collection in order to identify HPV DNA through PCR and anal cytology. An anal biopsy was obtained in cases of abnormal anal cytology or major alterations in high resolution anoscopy (HRA).
RESULTS
Thirty-two percent (n=37/115) of HRA were normal and 63.5% (n=73/115) showed acetowhite epithelium. Twenty-two percent (n=26/115) of anal cytologies were abnormal. Among the latter, 12.2% (n=14/26) were low-grade anal intraepithelial lesions and 3.4% (n=4/26) were high-grade anal intraepithelial lesions. Twenty-two anal biopsies were performed, 13.7% of which (n=3/22) were grade 2 anal intraepithelial neoplasia (AIN2) and 9% (n=2/22) were grade 3 AIN. Th HPV DNA was identified in 72.1% of cases (n=83/115).
CONCLUSION
Women with CIN grade 2/3 showed a high prevalence of anal HPV infection and HPV-induced lesions.
目的
确定宫颈上皮内瘤变（CIN）2/3级女性肛管中HPV诱导病变的患病率。
方法
2008年12月至2009年6月在巴西东北部伯南布哥州进行了一项横断面研究。仅纳入CIN 2/3级的女性，排除首次就诊时无法接受肛门镜检查的女性。使用细胞刷收集样本，通过PCR和肛门细胞学检查鉴定HPV DNA。肛门细胞学异常或高分辨率肛门镜检查（HRA）有重大改变的病例进行肛门活检。
结果
HRA显示32%（n = 37/115）正常，63.5%（n = 73/115）显示醋酸白上皮。22%（n = 26/115）的肛门细胞学检查异常。其中，12.2%（n = 14/26）为低级别肛门上皮内瘤变，3.4%（n = 4/26）为高级别肛门上皮内瘤变。进行了22次肛门活检，其中13.7%（n = 3/22）为2级肛门上皮内瘤变（AIN2），9%（n = 2/22）为3级AIN。72.1%（n = 83/115）的病例中鉴定出HPV DNA。
结论
CIN 2/3级女性肛门HPV感染和HPV诱导病变的患病率较高。
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